Individual
MARTIE MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
876 S PARSONS AVE, BRANDON, FL 33511-6007
(813) 653-3359
(813) 662-9639
Mailing address
876 S PARSONS AVE, BRANDON, FL 33511-6007
(813) 653-3359
(813) 662-9639
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
ARNP3050652
FL
Other
Enumeration date
05/03/2006
Last updated
03/27/2009
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